Government of Brunei Darussalam Scholarship for Foreign Students Tenable In

GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS TENABLE IN

BRUNEI DARUSSALAM

ACADEMIC SESSION

APPLICATION FORM

CODE PROGRAMME NAME

FIRST CHOICE

SECOND CHOICE

INSTRUCTIONS TO APPLICANTS

1. Each applicant must complete this form, to be typed or written legibly.

2. The following documents MUST be submitted with the form:

i. Recent passport size photographs.

ii. Certified true copies of academic qualifications and other supporting documents (i.e. certificates, testimonials, transcripts).

iii. Certified English translations of supporting documents must be submitted for documents that are not in English.

iv. Applicant’s Statement of Purpose (Item 6).

v. Certified true copies of Birth Certificate and Passport.

vi. Security Vetting.

1. PERSONAL DETAILS (Please use BLOCK Letters)
Name (Please underline surname):
Passport No: / Citizenship:
Date of Birth ( dd/mm/yyyy ): / Country of Birth:
Religion: / Ethnicity:
Marital Status:
Single / Married / Divorced / Widowed* / Gender:
Male / Female*
Postal Address:
Telephone No.:______- ______- ______
(country code) (area code) (tel no.)
Mobile No.: ______- ______- ______
(country code) (area code) (tel no.) / Fax No.: ______- ______- ______
(country code) (area code) (tel no.)
E-mail address (if any):
(Candidates are strongly advised to provide either an email address or a fax number to facilitate correspondence)
Name of Parent/ Guardian/ Next of Kin*: ______
Relationship:______
Occupation / Designation: ______
Address: ______
______
Contact Number/ Email Address: ______

*delete as appropriate

2. ACADEMIC EXPERIENCE (Details of schools attended and academic qualifications)

A. Please state all schools attended from the age of 15

Name of School/ Institution / From / To / Qualifications Obtained

B. General Certificate of Education (Ordinary Level or Equivalent)

(Please state subjects that you have passed only)

Year / Subjects / Grade / Medium / Examination Body

C. General Certificate of Education (Advanced Level or Equivalent)

(Please state subjects that you have passed only)

Year / Subjects / Grade / Medium / Examination Body

D. Other Qualifications (Certificate/ National Certificate/ National Diploma/ Higher National Diploma/ First Degree)

Qualifications / Name of Institute & Country / Duration / Date Passed / Classification/ Grade / Medium of Instruction

E. Intended Qualification

Name of Programme/ Course / Subjects / Date of Results Expected

3. LANGUAGE PROFICIENCY

Language / Written / Reading / Spoken
English /
1 2 3 /
1 2 3 /
1 2 3
Others, Please State:
i. ……………….
ii. ………………. /
1 2 3
1 2 3 /
1 2 3
1 2 3 /
1 2 3
1 2 3

1: Good 2: Average 3: Poor

4. ACADEMIC DISTINCTIONS OR PRIZES RECEIVED

5. PROPOSED FUTURE CAREER

6. APPLICANT’S STATEMENT OF PURPOSE

In an essay of up to 200 words, describe your plan of study and/ or research you propose to pursue and relate this to your future career plan.

(You may include additional relevant material if there is insufficient space on this form).

Please tick if additional materials are enclosed

7. EMPLOYMENT EXPERIENCE (Please attach additional information if required)

Employer’s Name and Address / Position Held / Part-Time/
Full-Time / Dates
From / To

8. EXTRA CURRICULAR ACTIVITIES AND MEMBERSHIP IN ASSOCIATIONS

(Please attach additional information if required)

Year / Types of Activities (Sports, Cultural, Community Services etc.) / Level of Participation (e.g. Club, District, National, Regional, International etc.)

9. MEMBERSHIP IN ASSOCIATIONS/ PROFESSIONAL BODIES

(Please attach additional information if required)

Year / Associations/ Professional Bodies / Position Held

10. ACADEMIC AWARDS/ SCHOLARSHIP ACHIEVED IF ANY

Academic Awards/ Scholarship / Institution Name / Date Awarded

11. REFERENCES (Please give details of two (2) people who can act as referees to support your application. You should contact them yourself and request them to each complete a “Reference Letter” Form overleaf (C1 or C2) and submit the reference letter accordingly.

Applications cannot be considered unless references are received

Name of Referee / Job Title &
Organisation / Telephone &
Fax / E-mail address

12. DECLARATION

I hereby certify that all the statements made on this application and in the attached documents are true and correct. I have read the general terms and conditions laid down by the Government of Brunei Darussalam Scholarship for Foreign Students Scholarship Award for which I now apply. If awarded, I agree to abide by the terms and conditions of the award and shall return to my home country as soon as I complete my scheduled programme and will not extend my stay without valid reasons.

Date: …………………….. Signature: ………………………….

GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS
‘REFERENCE LETTER’

Assessment on the applicant’s academic ability.

1. Applicant’s Name: ……………………………………………………………………………………

Country: ......

Courses Applied: ......

2. In what capacity do you know the applicant? (e.g. teacher, supervisor, Principal etc.) …………………………………………………………………………………………………………...

3. How long have you known the applicant? ………………………………………………………….

4. Please evaluate the applicant’s performance by putting an X in the appropriate spaces below. Extra boxes are available if you wish to add up to three other qualities which you may find relevant to the assessment of the candidate (E.g. All-round ability, ingenuity, accountability, manual dexterity etc.)

Assessment on: / Excellent / Very Good / Good / Average / Below Average
Academic Record
English Proficiency
Creative Thinking
Research Ability
Industry/ Application
Judgement
Independent
Honesty
Motivation
Self Discipline

5. Is the applicant’s proficiency in English Language (oral and written) adequate to meet the standard required? Please comment.

6. Please give your overall assessment on the applicant’s academic ability.

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Referee’s Name: …………………………………………………………………………………………..

Designation: ………………………………………………………………………………………………..

Address: …………………………………………………………………………………………………….

Tel No:………………………… Fax No: ……………………… Email address: ……………………..

Date: ………………………….. Signature: …………………………………………….

THANK YOU FOR YOUR ASSISTANCE. YOU MAY ENCLOSE THE COMPLETED REFERENCE LETTER IN A SEALED ENVELOPE AND SEND THE COMPLETED FORM TO:

Technical Assistance Unit

Scholarship, Training and Technical Assistance Division,

Department of Administration, Ministry of Foreign Affairs and Trade,

Jalan Subok, Bandar Seri Begawan, BD2710, Brunei Darussalam.

OR E-MAIL/ FAX TO:

E-mail: Fax No: (673) 2230903.

GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS
‘REFERENCE LETTER’

Assessment on the applicant’s academic ability.

1. Applicant’s Name: ……………………………………………………………………………………

Country: ......

Courses Applied: ......

3. How long have you known the applicant? ………………………………………………………….

5. Is the applicant’s proficiency in English Language (oral and written) adequate to meet the standard required? Please comment.

6. Please give your overall assessment on the applicant’s academic ability.

Referee’s Name: …………………………………………………………………………………………..

Designation: ………………………………………………………………………………………………..

Address: …………………………………………………………………………………………………….

Tel No:………………………… Fax No: ……………………… Email address: ……………………..

Date: ………………………….. Signature: …………………………………………….

THANK YOU FOR YOUR ASSISTANCE. YOU MAY ENCLOSE THE COMPLETED REFERENCE LETTER IN A SEALED ENVELOPE AND SEND THE COMPLETED FORM TO: Technical Assistance Unit

Scholarship, Training and Technical Assistance Division,

Department of Administration, Ministry of Foreign Affairs and Trade,

Jalan Subok, Bandar Seri Begawan, BD2710, Brunei Darussalam.

OR E-MAIL/ FAX TO:

E-mail: Fax No: (673) 2230903.

(The following endorsement must be completed on the top copy of the application by the Nominating Agency)

This candidate is nominated for consideration for an award and the following details are confirmed:

Initials of verifying officer

1. The underlining of the candidate’s name in question 1 correctly identifies his or her formal family name.
2. Evidence verified concerning date and place of birth and nationality.
3. References enclosed from the two (2) persons named in section 10.
4. Candidate’s medical certificate attached (if required at this stage)
5. Copies of the university or college transcript attached to each application form.
6. The candidate has sufficient language proficiency to enable him/ her to profit from his/ her proposed course of study if given in:
(a) / English
(b)

7. The candidate is / is not* in Government employment (*delete appropriately).

17. OFFICIAL DECLARATION (to be completed by the nominating government)
The ______
( Name of Department/ Ministry)
nominates ______on behalf of
the Government of ______for the Government of Brunei Darussalam
(Country)
Scholarship Award.
______
(Name) (Signature and Ministry’s stamp)
______
(Designation) (Address of Department / Ministry)
______- ______- ______
(Country Code) (Area Code) (Office Telephone No.)
______- ______- ______
(Country Code) (Area Code) (Office Fax No.)
PLEASE NOTE:
This application form must be duly completed and endorsed by the Ministry of Foreign Affairs or the relevant agency responsible for the Government of Brunei Darussalam Scholarship in your country.
Please attach relevant supporting documents, which are to be submitted with the form.
INCOMPLETE AND/ OR UNENDORSED FORMS WILL NOT BE PROCESSED.